Hypertension affects almost half of adults in the United States. Hypertension increases the risk of other problems such as heart disease, kidney disease or stroke. There are treatments that can help people control their blood pressure BP and reduce the risk of future medical problems. Many people with hypertension do not have their BP in control, and studies have shown disparities in hypertension treatment, meaning patients from certain racial or ethnic groups are less likely to receive effective treatment and less likely to have their BP in control.
Interventions to reduce these disparities could improve health and increase equity. Safety net health systems need information to decide where to focus efforts to improve the treatment of hypertension and reduce disparities. Developing this information requires research comparing practical options in real-world settings, so that the results of the research can be used directly by other health systems.
The Boston Hypertension Equity Alliance in Treatment, or BHEAT, study will compare two system-level interventionsโchanges that are put in place for an entire clinic or medical practice. Each intervention is designed to address one cause of disparities in hypertension treatment. Researchers will compare:. The study has three specific aims. Aim 2: Compare the details of how the two interventions are put into place to understand how other systems can use similar approaches.
The study team includes nine primary care sites in an urban safety-net system. All sites will begin with the remote monitoring intervention and then be randomly assigned to add the second intervention at three different points in time. Patients with hypertension will benefit from the knowledge generated about which interventions can be more effective when used in primary care.
Clinicians will benefit from having more effective systems for taking care of patients. Healthcare systems will benefit by identifying which methods for treating hypertension are more efficient and lead to better outcomes across their patient populations.
